Cardiovascular Health and Depression

Alexander Glassman, Peter A. Shapiro, Daniel E. Ford, Larry Culpepper, Mitchell S. Finkel, J. Robert Swenson, J. Thomas Bigger, Bruce L. Rollman, Thomas N. Wise

Research output: Contribution to journalReview articlepeer-review

Abstract

Research has shown that depression increases the likelihood that otherwise healthy people will develop ischemic heart disease (IHD) and worsens the prognosis of patients who already have IHD. Moreover, concerns about safety (e.g., cardiac side effects, drug-drug interactions) have caused physicians to be hesitant about using antidepressant agents in patients with IHD. This article is based on a recent roundtable of experts who met to discuss risk, diagnosis, and treatment options for depression in patients with IHD. This article reviews clinical and epidemiological studies that have described a link between depression and the subsequent development of IHD and have examined the role of depression as a predictor of cardiac events in patients with existing IHD. The article addresses the issue of whether depression can be safely and efficaciously treated both in patients with stable IHD and in those with acute coronary syndromes. The authors discuss safety issues related to the potential for interactions between antidepressants and cardiovascular medications, the use of nonpharmacologic treatment options such as psychosocial interventions, and the effect of antidepressant therapy on quality of life in patients with IHD. The article concludes with practical clinical guidance concerning the management of depression in patients who have recently experienced myocardial infarction.

Original languageEnglish (US)
Pages (from-to)409-421
Number of pages13
JournalJournal of psychiatric practice
Volume9
Issue number6
DOIs
StatePublished - Nov 1 2003

Keywords

  • Antidepressants
  • Bupropion
  • Cardiovascular illness
  • Cognitive-behavioral therapy
  • Depression
  • Fluoxetine
  • Ischemic heart disease
  • Paroxetine
  • Psychosocial treatment
  • Selective serotonin reuptake inhibitors
  • Sertraline
  • Tricyclic antidepressants
  • Venlafaxine

ASJC Scopus subject areas

  • Psychiatry and Mental health

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